Rhinoscleroma: an unusual form of presentation and evolution. Case report

Rhinoscleroma is a chronic infectious condition found mainly in patients living in underdeveloped regions. It affects the respiratory tract (in 95% of the cases the nasal cavity is the first affected), but it can also involve the orbit, the middle ear, the lip, the gums and the cutaneous tissue. It is linked to infection with Klebsiella rhinoscleromatis. Females are far more frequently affected than males. Symptoms typically appear in the second and third decades of life. Diagnosis is confirmed based on the pathology result of the biopsy and also by microbiology exam, but it has a low-rate specificity. Treatment consists of prolonged antibiotic therapy and surgical intervention. Follow-up of the patient is necessary due to the high relapse rate of the disease.

We present a rare case of rhinoscleroma presented initially with cutaneous manifestations, which progressed rapidly causing invasion of the right frontal sinus by lysis of its anterior wall.